{"id":19634,"date":"2016-11-18T17:22:16","date_gmt":"2016-11-18T22:22:16","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/bluestar-managing-diabetes-one-click-at-a-time\/"},"modified":"2016-11-18T17:27:50","modified_gmt":"2016-11-18T22:27:50","slug":"bluestar-managing-diabetes-one-click-at-a-time","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/bluestar-managing-diabetes-one-click-at-a-time\/","title":{"rendered":"BlueStar \u2013 Managing diabetes one click at a time"},"content":{"rendered":"

Fitbit, 23andMe, Pillpack \u2013 digital business models and products are undeniably breaking into every dimension of healthcare. Funding for digital health has risen dramatically over the past few years, jumping from $1.1 billion to $4.5 billion between 2011 and 2015. (1) Bluestar \u2013 dubbed \u201cone of the 5 Healthcare Tech Startups to Watch in 2016\u201d by Forbes \u2013 is a tangible example of how digital technologies change patient\u2019s lives and help them achieve better outcomes at a lower cost. (2)<\/p>\n

Differentiated business model and operating model<\/strong><\/p>\n

Diabetes presents a real and increasing problem in the developed world. Today in the US, 25.8 million people or 8.3% of the population are living with the disease, resulting in an estimated cost of $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity. (3)<\/p>\n

Until recently type 2 patients had to determine when to test their blood glucose levels and take tablets or doses of insulin largely by themselves. Bluestar presents the first mobile prescription therapy approved by the FDA and reimbursed by health insurers \u2013 a true revolution in the healthcare space. Prescribed by physicians just like normal drugs, the app plays on the various aspects of mobile technology to simplify patient\u2019s management of the disease. (4)(5)<\/p>\n

The app offers virtual \u201creal-time, motivational, behavioral and educational coaching\u201d. (6) Patients are asked to regularly input their blood glucose levels, the amount of carbs consumed, doses of insulin injected and their mood. Building off the patient\u2019s historic data and Bluestar\u2019s proprietary analytic systems, the patient then receives immediate, personalized guidance, like for example the suggestion to eat 15g carbohydrates, paired with options of what portions of food would fulfill the nutritional requirement. As such, Bluestar acts as a reliable, judgment-free advisor in the patient\u2019s daily actions and helping the patient so that the disease does not have to be constantly on top of his mind.<\/p>\n

Since all results are stored and analyzed, patients are able to track their progress over time and motivated to take additional steps to follow a healthy lifestyle. A wide array of available information on nutrition and exercising supports these endeavors.<\/p>\n

Bluestar also facilitates entirely new ways of communicating with clinical stakeholders. In the app, patients can text-message with Bluestar\u2019s remote expert team to clarify questions and concerns remotely. When patients come to see their physician, the app creates automatic reports about the patients\u2019 \u201ctrack-record\u201d and even recommends treatment adjustments to their medication regimen if required, based on evidence from the app. Finally, patients are also reminded upcoming appointments or when it would be time to see a certain healthcare provider again.<\/p>\n

\"Screenshots<\/p>\n

In clinical trials the app demonstrated superior outcomes compared to patients receiving usual care. Average blood sugar levels dropped by 1.9% on average for participants over the course of three months, whereas they showed only a decline of 0.7% pursuing traditional disease management. (7) Admission to emergency rooms and hospitals fell by 58% for patients using the app for more than 12 months. (8)<\/p>\n

At the same Bluestar is priced at 30-50% less than branded diabetes drugs, which cost around $200 to $300 a month. (9) Part of those cost savings can be attributed to the fact that Bluestar had a much quicker and cheaper development cycle than traditional pharmaceutical drug companies would typically undergo. To illustrate this, clinical trials for a neurology drug evolve around $36\u2019000 per patient, whereas digital health-start-ups spend typically only $1\u2019000 to $5\u2019000 per patient in a clinical trial, given that much of the extensive efforts required to recruit, manage and test patients can be done remotely. (10) Moreover, the fact that the app can be simply downloaded practically cuts out all manufacturing and distribution costs.<\/p>\n

Additional areas for improvement<\/strong><\/p>\n

Bluestar has recently announced a partnership with J&J to link their app to LifeScan\u2019s Bluetooth-enabled OneTouch Verio Flex blood glucose monitoring system to simplify\u00a0the entry of data. (11) While this presents a great opportunity, there are further steps\u00a0to transform Bluestar into a truly integrated and holistic management system for diabetes patients:<\/p>\n